A29-08 Pulmonary Rehabilitation in Veterans With Interstitial Lung Disease

Abstract Introduction Interstitial Lung Diseases (ILDs) are a heterogeneous group of disorders characterized by high mortality and morbidity. Veterans have an increased risk for developing ILD due to unique environmental and occupational exposures during military service. Patients with ILD frequently experience debilitating dyspnea, exercise intolerance, social withdrawal, and impaired quality of life which do not improve with currently approved pharmacologic therapies. Pulmonary Rehabilitation (PR) is a proven, guideline-endorsed intervention that enhances exercise capacity, reduces symptoms, and improves quality of life in ILD. This study aims to evaluate PR utilization in veterans with ILD. Methods We used the Department of Veterans Affairs’ (VA) Corporate Data Warehouse to identify an International Classification of Diseases (ICD) 9 and 10 code based national cohort of veterans with ILD from 1999-2022. Since not all VA centers provide PR services in house, we further limited our analysis to veterans who were diagnosed with ILD starting in the year 2015 when the Veterans Choice Program, which covered non-VA care, went into effect. Results We identified 153,219 out of 13,994,327 veterans with ILD from 1999-2022. A total of 48,472 veterans with ILD from 2015-2022 were analyzed and their characteristics are noted in Table 1. This was a mostly older White male cohort of former or current smokers. The mean age was 68.59(±12.81). 36,110(74.5%) identified as White, 8,729(18.01%) identified as Black, and 2,685(5.54%) identified as Hispanic. 45,220(93.29%) were male and 3,252(6.71%) were female. 21,106(68.19%) had a smoking history. 8,451(17.43%) were Gulf War veterans and 2024(4.18%) were Operation Enduring Freedom (OEF) veterans. 7,809(16.11%) were exposed to Agent Orange. 53% of the cohort died during follow up with an average time to death from diagnosis of 2.52(±2.20) years. Only 2721(5.6%) of veterans with ILD received PR through the VA (at the VA medical center or at a non-VA center through the VA). Since only 27% of the cohort had any pulmonary function data available in the Corporate Data Warehouse, we were unable to assess how disease severity might have affected PR status. Additionally, the non-VA claims data in the Corporate Data Warehouse does not capture the entirety of the care veterans receive outside of the VA medical centers. Therefore, the diagnosis of ILD and the receipt of PR may both be underestimated in our analysis. Conclusions Like chronic obstructive pulmonary disease, PR is underutilized in the veteran population with ILD. Virtual PR could improve utilization of PR in patients with ILD. This abstract is funded by: None